Sacral nerve stimulation results may be improved by electrodiagnostic techniques

Sacral nerve electrical stimulation (sacral neuromodulation) therapy for patients with refractory urge incontinence, frequency and urgency, and non-obstructive retention yields an effective 75%-80% success rate. Electrodes are surgically implanted if initial percutaneous stimulation testing has a successful clinical response. Unfortunately, up to 50% of patients are denied surgical implantation because of an unsuccessful response to the test stimulation. In this descriptive study, adding electrodiagnostic monitoring to the currently used biological monitoring techniques was associated with a reduction in the number of tested patients denied implantation to 20%. These findings suggest that the incorporation of electrodiagnostic techniques may improve the clinical efficacy of sacral stimulation therapy. Randomized prospective testing of this hypothesis is suggested.